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They are just a few blocks from one another, but the three Scranton hospitals vary significantly in what they charge patients for the same treatment - in some cases, by as much as 88 percent.

Meanwhile, two Wilkes-Barre hospitals about five miles apart also have major disparities in what they bill for the same procedure, according to hospital charge data released Wednesday by the federal government.

It is the first time the government is publicly revealing how much hospitals charge. The data, posted on the Centers for Medicare & Medicaid Services website, show significant variation across the country, and even within communities and health networks.

The database lists the average charges for the 100 most common Medicare inpatient services at more than 3,000 hospitals. The prices, from 2011, represent about 60 percent of Medicare inpatient cases.

"Hospitals that charge two or three times the going rate will rightfully face scrutiny," Health and Human Services Secretary Kathleen Sebelius told reporters.

And consumers will get insight into a mystifying system that too often leaves them with little way of knowing what a hospital will charge or what their insurance companies are paying for treatments, Ms. Sebelius said.

For example, Moses Taylor Hospital in Scranton charged, on average, $52,495 to treat a patient with kidney failure, while Geisinger Community Medical Center billed $40,086 and Regional Hospital of Scranton charged $27,848. Wilkes-Barre General Hospital charged $43,762 to treat that same complaint and Geisinger Wyoming Valley Medical Center charged $43,582.

Only people who "don't have any governmental or commercial insurance coverage, or don't qualify for uncompensated care" pay it, he said.

In 2011, Geisinger Health Systems merged with CMC and its affiliated facilities. And the for-profit company Community Health Systems Inc. acquired both Regional Hospital of Scranton, then known as Mercy Hospital, and Moses Taylor.

"It is only recently that the hospitals of Commonwealth Health have become an affiliated system," said James McGuire, spokesman for Commonwealth Health, which has eight area hospitals, including Moses Taylor, Regional Hospital of Scranton and Wilkes-Barre General. "They have operated for many years as independent facilities with unique charge structures."

The Times-Tribune used four medical conditions included in the report in this article: heart attack, major joint replacement, kidney failure and simple pneumonia.

In three of the four categories, the two Wilkes-Barre hospitals charged more than the Scranton hospitals for the same treatments.

Wilkes-Barre General billed $72,765 for a major joint replacement or reattachment of a lower extremity - $31,025 more than GCMC and $34,500 more than Regional Hospital.

Wilkes-Barre General also charged the most to treat a heart attack and simple pneumonia. Regional Hospital billed the least to treat all the conditions except a heart attack.

Mr. Van Stone explained the discrepancies by saying Geisinger has a pricing policy that compares its hospitals to similar facilities. For example, he said, officials compare the Medical Center in Danville, which is a level one trauma center and teaching facility, when determining the gross charge for a procedure or test.

"There are very few patients who pay the gross charge," he said. He said anyone who has some sort of insurance receives a reimbursement.

Mr. McGuire attributed the varying charges to the "unique mix of payers, patients and services," at hospitals.

"It is important to note that what hospitals charge rarely reflects what they are actually paid by the government or private insurers," he said in a statement.

Commercial insurers negotiate discounts on behalf of their covered members, he said. He acknowledged the importance of transparency in health care - one of the main reasons for the report. But said "understanding charges is difficult and as is shown in the CMS report there is a considerable difference between what hospitals charge and what is actually paid."

Consumer advocates said making the charges public is significant, even if most patients don't pay those rates, according to an Associated Press report.

Dr. David Goodman, co-author of the Dartmouth Atlas of Health Care, said, "It does show how crazy the system really is, and it needs some reform."

Dr. Goodman argues that hospitals should be required to go further and post the charges that patients actually pay out-of-pocket, depending on what medical coverage they have. The Dartmouth Institute for Health Policy has long found wide geographic variation in Medicare payments for the similarly ill, yet people who receive more expensive care don't necessarily receive better care. Sometimes hospitals just add tests or treatments they don't really need, according to the Associated Press report.

A hospital's charges are akin to a car dealership's "list price." Hospitals say they frequently give discounts to the uninsured - $41 billion in financial aid in 2011.

But some people pay full price, or try to afford it, because they don't know they can seek a discount, said Chapin White of the nonprofit Center for Studying Health System Change.

And even for those who do bargain, the listed charge "is the opening bid in the hospital's attempt to get as much money as possible out of you," he said.

The department also is making $87 million in federal money available as grants to states to improve their hospital rate review programs, research why hospital charges vary so much, and get more information to patients.

Todd Park, an assistant to President Barack Obama on technology issues, said he envisions entrepreneurs creating apps to help consumers compare hospitals and researchers combing through the data to explain the cost differences.

"Transparent marketplaces are more competitive, and more competitive marketplaces drive down costs," Mr. Park told reporters at the White House. "And that's certainly the hope here."

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